SmithRx

Senior Clinical Review Operations Pharmacist

Undisclosed

Remote. The employer does not say where candidates may be based.

Location not stated

Employer listed it 12 days ago · Added 10 days ago

First listed 12 days ago and still open.

Salary

$173,400 to $204,000

Location

Location not stated

Timezone

Not stated

Contract

Full-time

Experience

Senior

What the advert says

Quoted word for word from the employer's advert. Where it says nothing, we say so.

Working hours: Not mentioned in the advert
Where you can work from: Well-stocked kitchen in office locations
Contract: Not mentioned in the advert
Experience asked for: Not mentioned in the advert
Pay: Zone A Pay Range

Remote flexibility

Undisclosed

The listing is advertised as remote but does not state which countries or regions candidates may work from.

Why this role is Undisclosed

We only label a role Work from anywhere, Region restricted or Work from home when the employer's own wording says so. We checked this advert under our current rules and found no country or region eligibility requirement in it. We don't guess, so it stays Undisclosed until the employer publishes enough location information. Here is exactly what the advert left out.

Countries you can work from: Not stated. The advert only gives "Remote", which names no country you must live in.
Whether the work is remote: Never mentioned. The role reached us through a remote job board, but the advert itself doesn't say the work is remote.
Working hours: Not stated. No timezone overlap or set hours are mentioned, so assume nothing either way.

Worth a look all the same. Missing wording is usually a rushed job posting rather than a closed door, so ask where you can be based in your first message, before you write a tailored application.

What the employer says

Source listing states candidate location: "Remote"

What Nomaders makes of it

No residency or region requirement found in the job description
Check with the employer before assuming you can work from abroad

The quotes above are the employer's own words; the reading is ours. Always check the original listing and employment terms before working from another country.

Before you apply

Questions worth asking: Nomaders interpretation

The advert does not say whether this is employment or a contractor arrangement. Ask, as it affects tax and benefits.

Produced automatically from this advert's text; not reviewed by a person. The employer's own page is the final word.

About the role

Who We Are:

SmithRx is a rapidly growing, venture-backed Health-Tech company. Our mission is to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector by building a next-generation drug acquisition platform driven by cutting edge technology, innovative cost saving tools, and best-in-class customer service. With hundreds of thousands of members onboarded since 2016, SmithRx has a solution that is resonating with clients all across the country.

We pride ourselves for our mission-driven and collaborative culture that inspires our employees to do their best work. We believe that the U.S healthcare system is in need of transformation, and we come to work each day dedicated to making that change a reality. At our core, we are guided by our company values:

Integrity: Our purpose guides our actions and gives us confidence in the path ahead. With unwavering honesty and dependability, we embrace the pressure of challenging the old and exemplify ethical leadership to create the new.

Courage: We face continuous challenges with grit and resilience. We embrace the discomfort of the unknown by balancing autonomy with empathy, and ownership with vulnerability. We boldly challenge the status quo to keep moving forward—always.

Together: The success of SmithRx reflects the strength of our partnerships and the commitment of our team. Our shared values bind us together and make us one. When one falls, we all fall; when one rises, we all rise.

Job Summary:

SmithRx is looking for a motivated Senior Clinical Review Operations Pharmacist to serve as a clinical subject matter expert and key operational driver within our Prior Authorization team. This individual contributor role is pivotal in maintaining high-quality clinical reviews, ensuring adherence to turnaround times, and delivering exceptional member experiences. Your primary focus will be building tools to support prior authorization evaluations, driving process improvements, mentoring peer pharmacists on clinical protocols, and serving as a key cross-functional innovator to scale our clinical operations.

What you will do:

Process & Technology Optimization: Identify operational process gaps and champion technology-driven solutions to improve throughput, scalability, and workflow efficiency.

Clinical Mentorship & Quality Assurance: Serve as a clinical peer lead, providing guidance, coaching, and onboarding support to fellow pharmacists to foster clinical consistency and quality.

Complex Escalations: Act as a senior operational contact for complex clinical cases, escalated coverage determinations, and appeals.

Cross-Functional Collaboration: Partner with internal teams to troubleshoot eligibility questions, claims adjudication, and benefit design nuances.

Clinical Policy & P&T Committee Support: Collaborate with clinical leadership and the Pharmacy and Therapeutics (P&T) Committee to help develop, refine, and review clinical criteria for medications requiring prior authorization.

Performance & SLAs: Consistently meet or exceed individual target KPIs and turn-around-time (TAT) SLAs to maintain seamless operating standards.

Change Champion: Drive adoption of new technology, workflow tools, and updated clinical protocols across the Clinical Review team.

What you will bring to SmithRx:

5+ years of health plan or Pharmacy Benefit Manager (PBM) experience, specifically involved in prior authorization review and clinical operations.

Demonstrated expertise as a clinical subject matter expert with a track record of driving process improvements or technology-driven efficiencies.

Active Pharmacist License (unrestricted) required.

Bachelor’s degree in Pharmacy or Doctor of Pharmacy (PharmD) required.

Strong proficiency with Mac, MS Office, and G-Suite platforms.

High degree of empathy with excellent active listening and communication skills to clearly convey complex clinical information to members, providers, and internal stakeholders.

Proven self-starter with superior multitasking, time management, and problem-solving abilities in a fast-paced environment.

Requirements

·5+ years of health plan or Pharmacy Benefit Manager (PBM) experience, specifically involved in prior authorization review and clinical operations.
·Demonstrated expertise as a clinical subject matter expert with a track record of driving process improvements or technology-driven efficiencies.
·Active Pharmacist License (unrestricted) required.
·Bachelor’s degree in Pharmacy or Doctor of Pharmacy (PharmD) required.
·Strong proficiency with Mac, MS Office, and G-Suite platforms.

Benefits

·401(k) Retirement Savings Program
·Short-term and long-term disability
·Discretionary Paid Time Off
·Paid Company Holidays
·Wellness Benefits

How to apply

1Check the flexibility label above, undisclosed, matches where you plan to live and work.
2Tailor your CV to the role at SmithRx, mentioning your remote working experience.
3Apply directly on the employer's careers page using the button below. Nomaders never handles your application.

Found 11d ago. Last checked today. Always confirm the details on the original posting, salary and location can change after publication.

Listing sourced from Company boards.

$173,400 to $204,000 · You'll be taken to the employer's careers page.